Tropical treatment of new world cutaneous leishmaniasis in Belize: a clinical study

BACKGROUND: Many studies have been performed during the past decade to find an effective topical therapy for cutaneous leishmaniasis (CL). OBJECTIVE: Our purpose was to evaluate the effect of paromomycin ointment (P-ointment) containing 15 percent paromomycin sulfate and 12 percent methylbenzethonium chloride on Belizean patients with New World CL. METHODS: Fifty-three patients were treated twice daily for 14 to 21 days with P-ointment. RESULTS: Sixty-eight percent of the patients healed, 6 percent had a delayed cure, and 26 percent did not respond. No toxic effects from the ointment were observed. CONCLUSION: Topical paromomycin is as efficacious in the treatment of New World CL as other currently accepted modalities that are potentially more toxic (AU)

A search for leptospirosis in Belize - abstract

Subjects in four urban communities, nine rural communities and six schools in Belize were examined for leptospiral agglutinins in June 1984. Seropositivity rates at titres of >1:50 were 22 percent for urban community subjects, 37 percent for rural community subjects and 11.5 percent for school pupils. At titres of >1:100 the rates were 17 percent, 26 percent and 7.5 percent, respectively. These latter figures are remarkably similar to those for Barbados. If the pathogenicity of the predominant serovars in the two territories is comparable, an average of about 26 severe cases a year could be expected in Belize (approximately 18 per 100,000 population). The finding of at least one current case among 11 febrile patients examined in a two-week period is consistent with these expected findings. The serovars most commonly infecting humans in Belize appear to belong to the Australis, Autumnalis, Icterohaemorrhagiae and Panama serogroups. Among the cattle examined, reactions to antigens in the Hebdomadis II serogroup were predominant, probably as a result of importation practices. However, serogroup Australis was also commonly found in cattle, as well as in pigs and sheep. Livestock animals could be a major source of human infection in Belize (AU)

Progressive supranuclear palsy

The clinical features of the Steele-Richardson-Olszewski, occurring in a 62-year-old Jamaican male, are described. The patient is alive four years after the onset of symptoms (AU)

Pre-excitation at the University Hospital of the West Indies - abstract

The aim of this study was to assess the overall prevalence of pre-excitation syndromes and correlate their clinical association with refractory and life-threatening arrhythmias. All electrocardiograms (ECGs) taken at the University Hospital of the West Indies (UWHI) between January and December, 1979 were analyzed for pre-excitation syndromes. Pertinent clinical data were extracted from hospital records. A total of 6,332 ECGs were reviewed. Fifty-two patients (ages 5 to 83 years) with pre-excitation were detected (8 per 1,000). Of these, 43 had the typical delta waves with variable PR intervals and QRS complexes, while 9 had short PR with normal QRS. These syndromes were associated with a broad spectrum of clinical entities, both cardiac and non-cardiac. The majority of patients were free of dysrhythmias (62 per cent), with pre-excitation being an incidental electrocardiographic (ECG) finding. Twenty patients (38 per cent) had significant arrhythmias, the majority of which were supraventricular. In some, these arrhythmias required frequent hospitalizations or clinic visits. At times, the arrhythmias were refractory to drug therapy and responded only to electrical cardioversion. Two of these patients (4 per cent of the series) died in refractory ventricular tachycardia and fibrillation. Both patients had associated Barlow Syndrome. Pre-excitation is not a rare entity in Jamaica. It appears to be a benign incidental ECG finding in the majority of patients seen at UHWI. However, when it is found in patients with the Barlow Syndrome, rheumatic fever and rheumatic heart disease, sickle cell disease with cardiomegaly and infection or renal failure, congestive cardiomyopathy, congenital heart disease and thyrotoxicosis, it can lead to potentially life-threatening arrhythmias. We recommend therefore that careful cardiac assessment be performed in all patients with ECG diagnosis of pre-excitation to detect those patients at high risk of dying suddenly (AU)